Abstract
The maintenance and sharing of electronic medical records are one of the essential tasks in the medical treatment combination. Traditional cloud-based electronic medical record storage system is difficult to realize data security sharing. The tamper resistance and traceability of blockchain technology provide the possibility for the sharing of highly sensitive medical data. This paper proposes a safe sharing scheme of stroke electronic medical records based on the consortium blockchain. The scheme adopts the storage method of ciphertext of medical records stored in the cloud and index of medical records stored on the blockchain. The privacy protection mechanism proposed in this paper innovatively combines proxy reencryption and searchable encryption which supports patient pseudoidentity search. The mechanism could achieve controllable sharing of medical records and precise search. According to the organizational characteristics of the stroke medical treatment combination, this paper proposes an improved Practical Byzantine Fault Tolerance mechanism to reach a consensus between consensus nodes. Then, the proposed scheme is analyzed and evaluated from three aspects of medical record integrity, user privacy, and data security. The results show that the scheme can not only ensure the privacy of patient identity information and private key data but also resist the tampering and deletion attacks of internal and external malicious nodes on the medical record data. Therefore, the proposed scheme is conducive to the improvement of the timeliness of stroke treatment and the safe sharing of electronic medical records in stroke medical treatment combination.
Highlights
Stroke is a major chronic noncommunicable disease that seriously endangers the health of Chinese people
Aiming at the application scenario of the stroke medical treatment combination, this paper proposes to improve the preselection node rules of the Practical Byzantine Fault Tolerance (PBFT) consensus mechanism according to the classification of medical institutions in the medical treatment combination to improve the reliability and safety of the system
The stroke electronic medical record sharing model based on the medical treatment combination referral treatment scenario proposed in this paper is displayed in Figure 2, which describes how the proposed scheme is used to store and share electronic medical records and how the entities interact to implement each phase of the scheme
Summary
Stroke is a major chronic noncommunicable disease that seriously endangers the health of Chinese people. It is the first cause of death and disability among adults in China. “Healthy China 2030 Plan” put forward a request for medical institutions above the secondary level to establish a scientific regional collaborative medical treatment system for acute cerebrovascular diseases and promote the construction of stroke centers [2]. The stroke medical treatment combination is to form a hierarchical treatment system based on the stroke center in the region and realize the standardized chronic disease management of stroke disease through the community-second-level hospital-tertiary hospital linkage and cooperation model [3].
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